Monitoring the incidence, duration and distribution of hyperglycaemia in very-low-birth-weight newborns and identifying associated factors
-
María del mar Fernández-Martínez
,
José Luis Gómez-Llorente
Abstract
Objectives
Hyperglycaemia is a common metabolic disorder in very-low-birth-weight (VLBW) infants and is associated with increased morbidity and mortality. The objective is to describe the incidence, duration, episodes and distribution of hyperglycaemia during the first 7 days of life of VLBW infants.
Methods
This is a prospective cohort study of 60 newborns weighing <1,500 g. Blood glucose levels were monitored with a continuous glucose monitoring system (CGMS) during the first 7 days of life. Hyperglycaemia was defined as glucose ≥180 mg/dL (≥10 mmol/L).
Results
Incidence of hyperglycaemia recorded with the CGMS was 36.6% (95%CI: 24.6–50.1). In almost 74.6±5.48% of these cases the duration of the episode exceeded 30 min and in 45.25% (95%CI: 2.26–57.82) it exceeded 2 h. The condition occurred most frequently during the first 72 h of life. One-fifth of cases were not detected with scheduled capillary tests and 84.6% of these had hyperglycaemic episode durations of 30 min or more. Agreement between the two techniques was very good (r=0.90, p<0.001) and the CGMS proved to be reliable, accurate and safe. Hyperglycaemia detected by a CGMS is associated with lower gestational age (OR: 0.66, p=0.002), lower birth weight (OR: 0.99, p=0.003), the use of ionotropic drugs (OR: 11.07, p=0.005) and death (OR: 10.59, p=0.03), and is more frequent in preterm infants with sepsis (OR: 2.73, p=0.1). No other association was observed.
Conclusions
A CGMS could be useful during the first week of life in VLBW infants due to the high incidence and significant duration of hyperglycaemia and the high proportion of cases that remain undetected. The advantage of the CGMS is that it is able to detect hyperglycaemic episodes that the capillary test does not.
Acknowledgments
The authors wish to acknowledge the assistance of the people who made this study possible: patients, parents, the University Hospital Torrecardenas and sanitary personnel. The efforts of everyone made it possible to improve our knowledge on hyperglycaemia in VLBW infants. We are also grateful to the parents or tutors of the patients who gave us written informed consent. The study protocol was approved by the institute’s committee on human research. All authors read and approved the final manuscript and there are no competing financial interests.
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study was approved by the corresponding Ethical Research Committee.
References
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Articles in the same Issue
- Frontmatter
- Review
- Exercise during pregnancy: a comparative review of guidelines
- Corner of Academy
- Women’s decisional conflict in the pathway of prenatal screening and testing: an explorative study within Finnish public maternity care
- Vascular anastomoses in intrauterine growth in monochorionic twins
- Effects of coronavirus 19 pandemic on maternal anxiety during pregnancy: a prospectic observational study
- Letter to the Editor
- Giving birth and dying alone in hospital during the COVID-19 pandemic – a time for shifting paradigm toward continuity of care
- Original Articles – Obstetrics
- The yield of chromosomal microarray testing for cases of abnormal fetal head circumference
- Expert advice about therapeutic exercise during pregnancy reduces the symptoms of sacroiliac dysfunction
- Trends of changes in the specific contribution of selected risk factors for shoulder dystocia over a period of more than two decades
- Birth tears after spontaneous and vacuum-assisted births with different vacuum cup systems – a retrospective cohort study
- Prevalence of vitamin D deficiency in Egyptian patients with pregnancy-induced hypertension
- Antenatal survey of women’s birthing choices in Qatar
- Original Article – Fetus
- Reference ranges for the fetal mitral, tricuspid, and interventricular septum annular plane systolic excursions (mitral annular plane systolic excursion, tricuspid annular plane systolic excursion, and septum annular plane systolic excursion) between 20 and 36 + 6 weeks of gestation
- Original Articles – Newborns
- Prediction of extubation success using the diaphragmatic electromyograph results in ventilated neonates
- Use of birth weight- vs. ultrasound-derived fetal weight classification methods: implications for detection of abnormal umbilical artery Doppler
- Investigating the preventive effect of vitamins C and E on preeclampsia in nulliparous pregnant women
- Monitoring the incidence, duration and distribution of hyperglycaemia in very-low-birth-weight newborns and identifying associated factors
